Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Psychiatry Clin Neurosci. 2015 Jan;69(1):34-42. doi: 10.1111/pcn.12214. Epub 2014 Aug 4.
Results from this randomized, placebo-controlled study of aripiprazole augmentation to antidepressant therapy (ADT) in Japanese patients with major depressive disorder (MDD) (the Aripiprazole Depression Multicenter Efficacy [ADMIRE] study) revealed that aripiprazole augmentation was superior to ADT alone and was well tolerated. In subgroup analyses, we investigated the influence of demographic- and disease-related factors on the observed responses. We also examined how individual symptom improvement was related to overall improvement in MDD.
Data from the ADMIRE study were analyzed. Subgroup analyses were performed on the primary outcome measures: the mean change in the Montgomery-Åsberg Depression Rating Scale (MADRS) total score from the end of selective serotonin reuptake inhibitor (SSRI)/serotonin norepinephrine reuptake inhibitor (SNRI) treatment to the end of the randomized treatment.
Changes in the MADRS total scores were consistently greater with aripiprazole than placebo in each of the subgroups. Efficacy was not related to sex, age, number of adequate ADT trials in the current episode, MDD diagnosis, number of depressive episodes, duration of the current episode, age at first depressive episode, time since the first depressive episode, type of SSRI/SNRI, or severity at the end of SSRI/SNRI treatment phase. Compared to placebo, aripiprazole resulted in significant and rapid improvement on seven of the 10 MADRS items, including sadness.
These post-hoc analyses indicated that aripiprazole was effective for a variety of Japanese patients with MDD who had exhibited inadequate responses to ADT. Additionally, we suggest that aripiprazole significantly and rapidly improved the core depressive symptoms.
本项在日本重度抑郁症(MDD)患者中进行的、针对抗抑郁药治疗(ADT)的阿立哌唑增效作用的随机、安慰剂对照研究(阿立哌唑抑郁症多中心疗效[ADMIRE]研究)结果表明,与 ADT 单药治疗相比,阿立哌唑增效治疗效果更优,且具有良好的耐受性。在亚组分析中,我们研究了人口统计学和疾病相关因素对观察到的反应的影响。我们还研究了个体症状改善与 MDD 整体改善的关系。
分析 ADMIRE 研究的数据。对主要疗效指标(从选择性 5-羟色胺再摄取抑制剂(SSRI)/5-羟色胺去甲肾上腺素再摄取抑制剂(SNRI)治疗结束到随机治疗结束时,蒙哥马利-阿斯伯格抑郁评定量表(MADRS)总分的平均变化)进行亚组分析。
在每个亚组中,阿立哌唑治疗组的 MADRS 总分变化均明显大于安慰剂组。疗效与性别、年龄、当前发作中 ADT 充分治疗试验次数、MDD 诊断、抑郁发作次数、当前发作持续时间、首次抑郁发作年龄、首次抑郁发作后时间、SSRI/SNRI 类型或 SSRI/SNRI 治疗阶段结束时的严重程度无关。与安慰剂相比,阿立哌唑治疗可显著快速改善 MADRS 十个项目中的七个项目,包括悲伤。
这些事后分析表明,阿立哌唑对各种对 ADT 反应不足的日本 MDD 患者均有效。此外,我们还发现阿立哌唑可显著快速改善核心抑郁症状。